Madison Medical Center

All Charges

Charge

Type

Setting

Price

COAGULATION DISORDERS

Facility

$27,521.10

Service Code	MSDRG 813
Min. Negotiated Rate	$13,760.55
Max. Negotiated Rate	$27,521.10
Rate for Payer: Aetna Medicare Advantage	$13,760.55
Rate for Payer: Cigna Commercial HMO & PPO	$13,760.55
Rate for Payer: Home State Health Plan Medicare Advantage	$13,760.55
Rate for Payer: Humana Commercial	$27,521.10
Rate for Payer: Humana Medicare Advantage	$13,760.55

COATED BLADE ELECTRADE

Facility

$45.00

Service Code	CPT Y7506
Hospital Charge Code	127283
Hospital Revenue Code	271
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$32.13
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$26.64
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$32.13
Rate for Payer: Cash Price	$40.50
Rate for Payer: UnitedHealthcare Commercial	$30.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20

COATED BLADE ELECTRADE

Facility

$45.00

Service Code	CPT Y7506
Hospital Charge Code	127283
Hospital Revenue Code	271
Rate for Payer: Cash Price	$40.50

COBALT

Facility

$360.00

Service Code	CPT 83018
Hospital Charge Code	2283180
Hospital Revenue Code	301
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$257.04
Rate for Payer: Aetna Better Health Medicaid/QHP	$19.76
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$213.12
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$257.04
Rate for Payer: Cash Price	$324.00
Rate for Payer: Cash Price	$324.00
Rate for Payer: Cash Price	$324.00
Rate for Payer: Cigna Commercial HMO & PPO	$21.96
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$19.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$21.14
Rate for Payer: Home State Health Plan Medicare Advantage	$21.96
Rate for Payer: Humana Commercial	$43.92
Rate for Payer: Humana Medicare Advantage	$21.96
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$19.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$129.60

COBALT

Facility

$360.00

Service Code	CPT 83018
Hospital Charge Code	2283180
Hospital Revenue Code	301
Rate for Payer: Cash Price	$324.00

COBAN, 2 ELASTIC 3M1582

Facility

$10.00

Hospital Charge Code	283784
Hospital Revenue Code	272
Rate for Payer: Cash Price	$9.00

COBAN, 2 ELASTIC 3M1582

Facility

$10.00

Hospital Charge Code	283784
Hospital Revenue Code	272
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$7.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$5.92
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$7.14
Rate for Payer: Cash Price	$9.00
Rate for Payer: UnitedHealthcare Commercial	$6.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.60

COBAN, 3IN 3M1583

Facility

$7.00

Hospital Charge Code	283785
Hospital Revenue Code	271
Rate for Payer: Cash Price	$6.30

COBAN, 3IN 3M1583

Facility

$7.00

Hospital Charge Code	283785
Hospital Revenue Code	271
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$5.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$4.14
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$5.00
Rate for Payer: Cash Price	$6.30
Rate for Payer: UnitedHealthcare Commercial	$4.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.52

COBAN ELASTIC 4 #1584

Facility

$55.00

Hospital Charge Code	283780
Hospital Revenue Code	271
Rate for Payer: Cash Price	$49.50

COBAN ELASTIC 4 #1584

Facility

$55.00

Hospital Charge Code	283780
Hospital Revenue Code	271
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$39.27
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$32.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$39.27
Rate for Payer: Cash Price	$49.50
Rate for Payer: UnitedHealthcare Commercial	$36.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.80

COCAINE

Facility

$186.00

Service Code	CPT 80353
Hospital Charge Code	2282522
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$132.80
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$110.11
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$132.80
Rate for Payer: Cash Price	$167.40
Rate for Payer: Cash Price	$167.40
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$66.96

COCAINE

Facility

$186.00

Service Code	CPT 80353
Hospital Charge Code	2282522
Hospital Revenue Code	301
Rate for Payer: Cash Price	$167.40

COCAINE ABUSE AND DEPENDENCE

Facility

$10,448.10

Service Code	APR-DRG 7742
Min. Negotiated Rate	$10,448.10
Max. Negotiated Rate	$10,448.10
Rate for Payer: Aetna Better Health Medicaid/QHP	$10,448.10
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10,448.10
Rate for Payer: Home State Health Plan Medicaid Managed Care	$10,448.10
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10,448.10

COCAINE ABUSE AND DEPENDENCE

Facility

$8,919.76

Service Code	APR-DRG 7741
Min. Negotiated Rate	$8,919.76
Max. Negotiated Rate	$8,919.76
Rate for Payer: Aetna Better Health Medicaid/QHP	$8,919.76
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$8,919.76
Rate for Payer: Home State Health Plan Medicaid Managed Care	$8,919.76
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$8,919.76

COCAINE ABUSE AND DEPENDENCE

Facility

$39,106.71

Service Code	APR-DRG 7744
Min. Negotiated Rate	$39,106.71
Max. Negotiated Rate	$39,106.71
Rate for Payer: Aetna Better Health Medicaid/QHP	$39,106.71
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$39,106.71
Rate for Payer: Home State Health Plan Medicaid Managed Care	$39,106.71
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$39,106.71

COCAINE ABUSE AND DEPENDENCE

Facility

$15,221.28

Service Code	APR-DRG 7743
Min. Negotiated Rate	$15,221.28
Max. Negotiated Rate	$15,221.28
Rate for Payer: Aetna Better Health Medicaid/QHP	$15,221.28
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$15,221.28
Rate for Payer: Home State Health Plan Medicaid Managed Care	$15,221.28
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$15,221.28

.COCAINE REFLEX CONFIRMATION

Facility

$110.00

Service Code	CPT 80353
Hospital Charge Code	221288
Hospital Revenue Code	301
Rate for Payer: Cash Price	$99.00

.COCAINE REFLEX CONFIRMATION

Facility

$110.00

Service Code	CPT 80353
Hospital Charge Code	221288
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$78.54
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$65.12
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$78.54
Rate for Payer: Cash Price	$99.00
Rate for Payer: Cash Price	$99.00
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$39.60

COC ALCOHOL COBALT MINES

Facility

$16.00

Service Code	CPT 80320
Hospital Charge Code	2242570
Hospital Revenue Code	301
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$21.00
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$9.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$11.42
Rate for Payer: Cash Price	$14.40
Rate for Payer: Cash Price	$14.40
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.76

COC ALCOHOL COBALT MINES

Facility

$16.00

Service Code	CPT 80320
Hospital Charge Code	2242570
Hospital Revenue Code	301
Rate for Payer: Cash Price	$14.40

COCCIDIOIDES AB

Facility

$113.00

Service Code	CPT 86635
Hospital Charge Code	223181
Hospital Revenue Code	301
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$80.68
Rate for Payer: Humana Commercial	$22.94
Rate for Payer: Aetna Better Health Medicaid/QHP	$10.32
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$66.90
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$80.68
Rate for Payer: Cash Price	$101.70
Rate for Payer: Cash Price	$101.70
Rate for Payer: Cash Price	$101.70
Rate for Payer: Cigna Commercial HMO & PPO	$11.47
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$10.32
Rate for Payer: Home State Health Plan Medicaid Managed Care	$11.04
Rate for Payer: Home State Health Plan Medicare Advantage	$11.47
Rate for Payer: Humana Medicare Advantage	$11.47
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$10.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.68

COCCIDIOIDES AB

Facility

$113.00

Service Code	CPT 86635
Hospital Charge Code	223181
Hospital Revenue Code	301
Rate for Payer: Cash Price	$101.70

COCCYX

Facility

$465.00

Service Code	CPT 72220
Hospital Charge Code	329127
Hospital Revenue Code	320
Rate for Payer: Cash Price	$418.50

COCCYX

Facility

$465.00

Service Code	CPT 72220
Hospital Charge Code	329127
Hospital Revenue Code	320
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$332.01
Rate for Payer: Aetna Better Health Medicaid/QHP	$78.45
Rate for Payer: Aetna Medicare Advantage	$88.91
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$275.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$332.01
Rate for Payer: Cash Price	$418.50
Rate for Payer: Cash Price	$418.50
Rate for Payer: Cash Price	$418.50
Rate for Payer: Cigna Commercial HMO & PPO	$88.91
Rate for Payer: Healthy Blue CHP/Medicaid Managed Care	$78.45
Rate for Payer: Home State Health Plan Medicaid Managed Care	$83.94
Rate for Payer: Home State Health Plan Medicare Advantage	$88.91
Rate for Payer: Humana Commercial	$177.82
Rate for Payer: Humana Medicare Advantage	$88.91
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Medicaid Managed Care	$78.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$167.40

Know your out-of-pocket cost for care.

All Charges